To register for your subsidy please fill in the details below.

Name

First Name

Last Name

Phone number

Email Address

Please select which level of course you will be attending

Please select the area you live in

Tasman

Nelson

Marlborough

Please select the age range you fit in to

What motorbike licence do you hold?

How did you hear about Ride to Live training subsidies?

Please select all applicable options.

R2L Christmas Promo Post on FB + Save a Mate's Life Promo

Ride To Live Facebook Page/Post

A Friend - SAVE A MATE'S LIFE PROMO (please enter mate's details below)

Radio Ad

Newspaper Article/Ad

At an Event

Attended a course previously

Other

If 'Other' please specify

If you qualify for the 'Save a Mate's Life' promo, please be sure to enter the first/last name and email address of your mate who referred you - we need this so we can contact them about their $20 fuel voucher.

Please note - Redemption value not to exceed $50.00 or the cost of the course whatever is the lesser; All or part of voucher not redeemable for cash or carryover; The subsidy cannot be used for any training in regard to licence courses or testing; It is at the discretion of Ride to Live on the number of vouchers a rider can register for.

To register for your subsidy please fill in the details below.

Marlborough

Nelson/Tasman